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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 34. Go back in thread:
Posted by Chloe on January 8, 2002, at 18:14:28
In reply to Re: Celexa Side Effects - temperature tweaking » Emme, posted by Mitch on January 8, 2002, at 9:55:13
Hi Emme,
I have not been following PB too closely lately. But I like to read about other microdosers!I am glad you found the Celexa liquid. Currently I am taking 1.7 mgs or .85 cc's. I find if I push the dose up much more than that I get one day of feeling a little racy and "good", followed by days of irritability. So I just stay at the lowest dose that doesn't make me irritable!
FYI, Celexa is the ONLY ssri that hasn't given me trouble with temp regulation and sweating. Prozac and Zoloft were awful. I would sweat, then feel chilled from being so "moist". Don't miss that. But I too wonder how such a small amount of an ssri can be useful. But I think Celexa is more potent, cleaner and targeted, so less is needed for particular folk like us.
Hang in there trying to figure this whole med thing out!
Take care,
Chloe
Posted by Chloe on January 8, 2002, at 18:29:27
In reply to Re: Celexa Side Effects - temperature tweaking » Emme, posted by Mitch on January 8, 2002, at 9:55:13
> >What I am "lean" on is mood stabilizer.
Mitch, ME TOO! Have you ever in your trials over the years tried verapamil? That one was recommended to me. But, I can't seem to tolerate any mood stablizers anymore. Even the "gentle" neurontin at 400 mgs is giving me the same problem they all do, intense scalp burning and hair pain.
Though I don't really think Neurontin does anything as an MS, it's very good for keeping anger and frustration at bay. Just keeping things calmer. But I am desperate for something for my cycling. My pdoc wants to add back 75 mgs of Lithium. But I am not optimistic this small amount will help(because I really needed about 600 mgs of lithobid to feel a stabilizing, AD effect), AND I don't fancy the non-extended release formula. I have heard that people who have responded well to Li can also have good luck with Calcium Channel Blockers...
Just wondering if you have had any experience with this one...
Many thanks and glad you are doing well with the WB!
Chloe
Posted by Mitch on January 8, 2002, at 23:24:38
In reply to Re: Neurontin/MS's-Mitch, posted by Chloe on January 8, 2002, at 18:29:27
> > >What I am "lean" on is mood stabilizer.
>
> Mitch, ME TOO! Have you ever in your trials over the years tried verapamil? That one was recommended to me. But, I can't seem to tolerate any mood stablizers anymore. Even the "gentle" neurontin at 400 mgs is giving me the same problem they all do, intense scalp burning and hair pain.
>
> Though I don't really think Neurontin does anything as an MS, it's very good for keeping anger and frustration at bay. Just keeping things calmer. But I am desperate for something for my cycling. My pdoc wants to add back 75 mgs of Lithium. But I am not optimistic this small amount will help(because I really needed about 600 mgs of lithobid to feel a stabilizing, AD effect), AND I don't fancy the non-extended release formula. I have heard that people who have responded well to Li can also have good luck with Calcium Channel Blockers...
>
> Just wondering if you have had any experience with this one...
> Many thanks and glad you are doing well with the WB!
> Chloe
Hello Chloe,Nope, I must say I haven't dealt with either verapamil or nimodipine. You do realize that Neurontin blocks voltage-dependent calcium-ion channels *selectively* whereas the others are generally a shotgun with more side-effects? It really sounds like from what you have posted that Lithium has done you more good than anything else (without having to take AP's and deal with dystonia, etc.). You did say that your TSH went up when you were on Lithium and there was a delay from the time you felt better on the Li to the time you started to experience the scalp stuff. Just my opinion...but I think that if you simply started to add back the lithium (say 150mg/bedtime) AND a *little* thyroxine (T4) to compensate AND work those up together maintaining your TSH within normal levels but in the hyperthyroid "half" of the bellcurve (instead of the hypothyroid half), your skin might be more forgiving and might find your way back to 600mg/day of lithium with your Neurontin *without* the scalp trips...might be worth considering. An important note: I remember you mentioning your *DAD* saying something about how the Li positively helped you. That is an important thing when someone else notices an improvement (whether or not you are aware of it).
Mitch
Posted by Emme on January 9, 2002, at 12:23:05
In reply to Re: Celexa liquid Emme, posted by Chloe on January 8, 2002, at 18:14:28
>
>
> Hi Emme,
> I have not been following PB too closely lately. But I like to read about other microdosers!
>
> I am glad you found the Celexa liquid. Currently I am taking 1.7 mgs or .85 cc's. I find if I push the dose up much more than that I get one day of feeling a little racy and "good", followed by days of irritability. So I just stay at the lowest dose that doesn't make me irritable!
> FYI, Celexa is the ONLY ssri that hasn't given me trouble with temp regulation and sweating. Prozac and Zoloft were awful. I would sweat, then feel chilled from being so "moist". Don't miss that. But I too wonder how such a small amount of an ssri can be useful. But I think Celexa is more potent, cleaner and targeted, so less is needed for particular folk like us.
> Hang in there trying to figure this whole med thing out!
> Take care,
> ChloeHi there Chloe,
I've been on and off following things on the board over the last few months. Often too tired or busy to write anything. That's amazing that you've got your Celexa so precisely figured out. Thank god for the liquid form, huh? I wonder how many doctors are creative enough to try their patients on really tiny doses when they have trouble with side effects. I think using a few drugs at very low doses is a good strategy for people like us and Mitch who are so sensitive to meds.Maybe I'd get more noticeable benefit from Celexa at a slightly higher dose - if I inch the dose up in slow teensy bits maybe I wouldn't feel too awful. At the moment I'm working on a rechallenge of Lamictal and want to see how that pans out before changing Celexa (one thing at a time). I have had one rash recurrence, for just one day - it had faded to very faint within a few hours. A dermatologist felt it was safe to continue the titration - and it's a damn slow titration. We will probably continue with it with careful superivision as long as any rashes continue to be brief and are not raised or otherwise menacing. And a little Neurontin's still on board for me.
Good luck finding mood stabilization options - I see Mitch's suggestion above. I cannot recall - have you had a dermatologist on board to offer opinions on how to handle the scalp/skin problems the anticonvulsants give you? Good luck.
Emme
Posted by Chloe on January 9, 2002, at 17:24:04
In reply to Re: Neurontin/MS's-Mitch » Chloe, posted by Mitch on January 8, 2002, at 23:24:38
Hi Mitch,
Yeah, I know lithium really works for me. But this scalp thing is no longer lithium related. After I d/c'd the lithium, the scalp burning came back, perhaps because I raised the Neurontin by 100 mg/day. SO, I have some neuropathy on my scalp. A dermatologist saw no rash or psoriasis, so he said that all these med trials have made my hair hypersensitive to pain...So, now I am on 20 mgs of amitriptyline for the pain. And I have to say there is a MILD reduction of the burning. I like the amitrip. Finally, I am sleeping at night! Wow, what a luxury that is! Low dose TCA's are underrated, IMHO.So I called my pdoc for her to call in some regular lithium. I really need to start something that will help with the suicidal thoughts. And I am sure Li will...If I can tolerate a high enough dose.
I will bring up the issue of watching my TSH my next appt.
I am just so discouraged and tired of feeling ok for about 36 hours, and then diving into a psychotic suicidal depression for a good 36 hours. I am finding that I am unsafe at times. And since I can't take the AAP's I am really in trouble.
Ho hum. I hope I hear from my pdoc so I can start the Li soon. But hey, what's the rush? I really don't want the bad side effects, esp the dried up and falling out hair. It is just starting to get a little shine back...Thanks for writing
Chloe
> Nope, I must say I haven't dealt with either verapamil or nimodipine. You do realize that Neurontin blocks voltage-dependent calcium-ion channels *selectively* whereas the others are generally a shotgun with more side-effects? It really sounds like from what you have posted that Lithium has done you more good than anything else (without having to take AP's and deal with dystonia, etc.). You did say that your TSH went up when you were on Lithium and there was a delay from the time you felt better on the Li to the time you started to experience the scalp stuff. Just my opinion...but I think that if you simply started to add back the lithium (say 150mg/bedtime) AND a *little* thyroxine (T4) to compensate AND work those up together maintaining your TSH within normal levels but in the hyperthyroid "half" of the bellcurve (instead of the hypothyroid half), your skin might be more forgiving and might find your way back to 600mg/day of lithium with your Neurontin *without* the scalp trips...might be worth considering. An important note: I remember you mentioning your *DAD* saying something about how the Li positively helped you. That is an important thing when someone else notices an improvement (whether or not you are aware of it).
>
> Mitch
Posted by Chloe on January 9, 2002, at 17:45:40
In reply to Re: Celexa liquid (and Lamictal rechallenge) » Chloe, posted by Emme on January 9, 2002, at 12:23:05
> > I've been on and off following things on the board over the last few months. Often too tired or busy to write anything. That's amazing that you've got your Celexa so precisely figured out. Thank god for the liquid form, huh? I wonder how many doctors are creative enough to try their patients on really tiny doses when they have trouble with side effects. I think using a few drugs at very low doses is a good strategy for people like us and Mitch who are so sensitive to meds.
Hi Emme,
I often think initial doses of meds are too high for the average person. I think it is so important to see how a person reacts to a small amouont of a med, before snowing a person with it. Smaller titrations lets the patient have a gentle introduction to a chemical. And a person is less likely to prematurely ditch a decent med if they don't get hit too hard by it's effects all at once. IMHO.> > Maybe I'd get more noticeable benefit from Celexa at a slightly higher dose - if I inch the dose up in slow teensy bits maybe I wouldn't feel too awful.
I go up by drops! I feel good between 1.65 and 1.75 mgs. This is less than twenty drops. It seems like nothing, but a little too much or too little has profound ramifications. (When you are ready), Since you have a syringe, you can be very exact about how much you measure out for each dose. You are the chemist!
> >At the moment I'm working on a rechallenge of Lamictal and want to see how that pans out before changing Celexa (one thing at a time). I have had one rash recurrence, for just one day - it had faded to very faint within a few hours. A dermatologist felt it was safe to continue the titration - and it's a damn slow titration. We will probably continue with it with careful superivision as long as any rashes continue to be brief and are not raised or otherwise menacing. And a little Neurontin's still on board for me.
ONe thing at a time is best! I am glad you are being closely watched by your doc and a derm. I wish I could have had a derm appointment 3 months ago when I was having the awful burning scalp on the lithium. If I could have been told THEN that it's a neuropathic path, I could have meerly added a TCA for the pain and kept the Li on board. BUt being a new patient at a dermatologists office made it so I could not get an appointment for 10 weeeks. I called every derm in the area. EVeryone had a huge waiting list. I was even willing to not use insurance and just pay cash! no dice. So I finally did get my appointment and it looks like I will resume the lithium...
> > Good luck finding mood stabilization options -
Thanks, Emme
Good luck with the Lamictal. Take it slow!
Chloe
Posted by Mitch on January 9, 2002, at 23:05:02
In reply to Re: Neurontin/MS's-Mitch » Mitch, posted by Chloe on January 9, 2002, at 17:24:04
> Hi Mitch,
> Yeah, I know lithium really works for me. But this scalp thing is no longer lithium related. After I d/c'd the lithium, the scalp burning came back, perhaps because I raised the Neurontin by 100 mg/day. SO, I have some neuropathy on my scalp. A dermatologist saw no rash or psoriasis, so he said that all these med trials have made my hair hypersensitive to pain...So, now I am on 20 mgs of amitriptyline for the pain. And I have to say there is a MILD reduction of the burning. I like the amitrip. Finally, I am sleeping at night! Wow, what a luxury that is! Low dose TCA's are underrated, IMHO.
>
> So I called my pdoc for her to call in some regular lithium. I really need to start something that will help with the suicidal thoughts. And I am sure Li will...If I can tolerate a high enough dose.
> I will bring up the issue of watching my TSH my next appt.
> I am just so discouraged and tired of feeling ok for about 36 hours, and then diving into a psychotic suicidal depression for a good 36 hours. I am finding that I am unsafe at times. And since I can't take the AAP's I am really in trouble.
> Ho hum. I hope I hear from my pdoc so I can start the Li soon. But hey, what's the rush? I really don't want the bad side effects, esp the dried up and falling out hair. It is just starting to get a little shine back...
>
> Thanks for writing
> Chloe
>
Low-dose TCA's *are* underrated. I was on 10mg amitriptyline twice daily for about a year or so. It knocked me out big time for sleeping. After about three weeks or so I felt an energizing effect during the day without any anxiety which was nice. Get this.. it seemed to have the most *mood stabilizing* effects of any TCA that I have tried! The only reason I stopped taking it was because I had friends that liked my hypomanic personality and they complained that I wasn't as goofy and eccentric anymore.Mitch
Posted by Chloe on January 10, 2002, at 19:36:21
In reply to Re: Neurontin/MS's-Mitch » Chloe, posted by Mitch on January 9, 2002, at 23:05:02
Mitch,
You took half your ami in the morning? How long did it take you to adjust? I think I might like the calming effect during the day...Oh, I am finding I am much more amiable to food. I can't tell if I am just less depressed and intouch with my body, or if it's the med. Did you notice an appetite increase on the ami?And gee, I hope I don't get "energized". But if it's without the anxiety I guess it would be ok. But I am so riddled with anxiety and angst at the moment, energized sounds awful!
I got a dew drop of lithium, 75 or so milligrams last night. I can't really tell, because the pill turned to dust when I tried to cut it into quarters. Why can't I just tolerate the whole damn thing??? But pdoc doesn't want to get my scalp all upset with a big slug of lithium. SO I think I probably took about 100 mgs HS, and I couldn't sleep very well. I forgot about how energizing lithium is initially for me. AND I think since it's regular release, it all got dumped into my system at once and really disrupted my sleep. I took todays lithium chip at lunch!
I am starting to blab a bit, but, I think I am going to switch brands and cut up the Eskilith CR pills into quarters. Those break evenly, and I can take 112.5 per day for a while and get a sustained release as well...It seems to make more sense to me to take a little higher, but consistant dose and get the controlled release. Any thoughts on this Li obsession of mine???
Take care,
Chloe
> Low-dose TCA's *are* underrated. I was on 10mg amitriptyline twice daily for about a year or so. It knocked me out big time for sleeping. After about three weeks or so I felt an energizing effect during the day without any anxiety which was nice. Get this.. it seemed to have the most *mood stabilizing* effects of any TCA that I have tried! The only reason I stopped taking it was because I had friends that liked my hypomanic personality and they complained that I wasn't as goofy and eccentric anymore.
>
> Mitch
Posted by Mitch on January 10, 2002, at 23:44:20
In reply to Re: Ami daytime dose?/Li » Mitch, posted by Chloe on January 10, 2002, at 19:36:21
> Mitch,
> You took half your ami in the morning? How long did it take you to adjust? I think I might like the calming effect during the day...Oh, I am finding I am much more amiable to food. I can't tell if I am just less depressed and intouch with my body, or if it's the med. Did you notice an appetite increase on the ami?Nope, I took 10mg at bedtime and 10mg at lunch the next day just before I went to work (I have nearly always worked 2nd shift jobs-even now!). There essentially was no adjustment really. I just got a little sedated and mellow in the afternoon. That worked out really well, because I noticed that it reduced grouchiness (hey, an AD that *reduces* grouchiness, that is the exception rather than the rule with me). I had to work with my DAD at the time, so dysphoria was something I was really trying to avoid as much as possible! Oh, any AD that is sedative will make you a little spacey for a while. Very little appetite change (not so with Remeron).
>
> And gee, I hope I don't get "energized". But if it's without the anxiety I guess it would be ok. But I am so riddled with anxiety and angst at the moment, energized sounds awful!
Oh, BTW, on TCA's you won't notice much antidepressant effect until you get the full two weeks worth of taking it. They are really strange that way. Anyhow, don't worry about getting energized! When I say that, what I really meant is that I am alert and attentive-I didn't feel the least agitated in any way. That happened on the amitriptyline after the 2 week period on it.>
> I got a dew drop of lithium, 75 or so milligrams last night. I can't really tell, because the pill turned to dust when I tried to cut it into quarters. Why can't I just tolerate the whole damn thing??? But pdoc doesn't want to get my scalp all upset with a big slug of lithium. SO I think I probably took about 100 mgs HS, and I couldn't sleep very well. I forgot about how energizing lithium is initially for me. AND I think since it's regular release, it all got dumped into my system at once and really disrupted my sleep. I took todays lithium chip at lunch!
>
> I am starting to blab a bit, but, I think I am going to switch brands and cut up the Eskilith CR pills into quarters. Those break evenly, and I can take 112.5 per day for a while and get a sustained release as well...It seems to make more sense to me to take a little higher, but consistant dose and get the controlled release. Any thoughts on this Li obsession of mine???>
> Take care,
> Chloe
I would say that is something of an obsession :-)
If you chop stuff you are going to lose sustained release characteristics generally. You know what I would do? Forget the Eskalith crap-there might be dyes that are in there that you may be reacting to-remember? Just get your generic immediate release lithium tabs and crush up a few of them and put them in some OJ. Real simple, and just pour out the milligrams you want and drink it-simple. I've done that before-it's easy-you are good at math.Mitch
Posted by Emme on January 11, 2002, at 15:04:41
In reply to Re: Celexa liquid (and Lamictal rechallenge) » Emme, posted by Chloe on January 9, 2002, at 17:45:40
> Hi Emme,
> I often think initial doses of meds are too high for the average person. I think it is so important to see how a person reacts to a small amouont of a med, before snowing a person with it. Smaller titrations lets the patient have a gentle introduction to a chemical. And a person is less likely to prematurely ditch a decent med if they don't get hit too hard by it's effects all at once. IMHO.
>
> > > Maybe I'd get more noticeable benefit from Celexa at a slightly higher dose - if I inch the dose up in slow teensy bits maybe I wouldn't feel too awful.
>
> I go up by drops! I feel good between 1.65 and 1.75 mgs. This is less than twenty drops. It seems like nothing, but a little too much or too little has profound ramifications. (When you are ready), Since you have a syringe, you can be very exact about how much you measure out for each dose. You are the chemist!
>
> > >At the moment I'm working on a rechallenge of Lamictal and want to see how that pans out before changing Celexa (one thing at a time). I have had one rash recurrence, for just one day - it had faded to very faint within a few hours. A dermatologist felt it was safe to continue the titration - and it's a damn slow titration. We will probably continue with it with careful superivision as long as any rashes continue to be brief and are not raised or otherwise menacing. And a little Neurontin's still on board for me.
>
> ONe thing at a time is best! I am glad you are being closely watched by your doc and a derm. I wish I could have had a derm appointment 3 months ago when I was having the awful burning scalp on the lithium. If I could have been told THEN that it's a neuropathic path, I could have meerly added a TCA for the pain and kept the Li on board. BUt being a new patient at a dermatologists office made it so I could not get an appointment for 10 weeeks. I called every derm in the area. EVeryone had a huge waiting list. I was even willing to not use insurance and just pay cash! no dice. So I finally did get my appointment and it looks like I will resume the lithium...
>
> > > Good luck finding mood stabilization options -
>
> Thanks, Emme
> Good luck with the Lamictal. Take it slow!
> ChloeHi Chloe,
So you're gonna go back to Li again. Yeah! I know you had success with that before - I hope it works out with the TCA added and that your scalp won't suffer too much.
I agree with you about starting people on low doses. Yeah, some people can jump right in at a higher dose, but I've known of people to give up on drugs due to side effects that might have been minimized if their doctors had started them off more slowly.
Your scalp problem also illustrates how important it is to have other doctors on board when treating a patient with a mood disorder. It is a whole body/soul illness and the medicines also affect the whole body. A good pdoc won't hesitate to get other opinions on board. I was lucky in the dermatology dept. My internist saw me right away, then made a phone call and sent me down the street a half an hour later to a dermatologist just to be safe - the words "lamictal" and "rash" get them moving pretty fast even if they are busy.Good news is, I think the lamictal may be starting to help. I'm a couple of steps back from the edge and also have some more energy. I made it to the gym 3 times this week for mild workouts, which feels like a miracle!
Keep us posted on your retrial with Li and the TCA.
Emme
P.S. You must be psychic. Yes, I'm a chemist (geochemist actually). After using syringes in the lab for so many things, it's funny to use one to squirt stuff into my mouth. :) Thanks for your support. My thanks also to Mitch for his earlier comments.
Posted by Chloe on January 11, 2002, at 16:09:22
In reply to Re: Ami daytime dose?/Li » Chloe, posted by Mitch on January 10, 2002, at 23:44:20
Mitch,
Ok, now you have done it, fueled my obsession!!:)Eskilith CR vs Lithobid:
The Eskilith CR is the hard yellowish tablet (450 mgs) that is scored. From what I have read about it, it's just very densely pressed Li and just breaks up slower on it's way out, so to speak.The lithobid (300 mgs), (which I prefer, since I don't seem to have the yucky side effects of increased sweating, nausea...) is the pink enteric coated tablet that isn't even digested in the stomach. This one I know I can't cut up. And you might be right about the dye causing some skin problems...I am so sensitive. I can't even use any creams or soaps with perfume, so a little dye might really be a culprit!
Anyway, So I think it's safe to cut a scored 450 Eskilith CR in half without messing with the potency or absorbtion, do you?...I did NOT know that you could dissolve the reg lithium in juice. Why don't pdocs tell me these things? I am glad you are there to mention it!...
However, I really do prefer the CR. I seem to have problems with reg. lithium and my blood sugar. I seem to get a surge of ?energy, jazziness?, and feel shaky. Then about 4 hours later, I have an energy, mood and BS crash. If I don't eat right away, I really lose it! That happened yesterday about 4 pm. Have you heard of the BS thing? I think I remember this from years ago, and that was one of the reason I didn't want to retry it...But I am glad I did. Li works very quickly for me. And there was some urgency as my therapist is headed out of town this week. I have been extremely needed related to my rapid cycling. I am so hoping that this small amount of li and the TCA will smooth things out so I can get through a day or two without a crisis...
Question? Why not retry the Amitriptline if it was really stabilizing for you? I think you said you are on Nortriptyline. How does that compare to Ami for you? My pdoc suggested that one as well. BUT I was on Ami in the eighties and liked the calming sedative effect. I recall that Nort. is more activating???
Thanks
Chloe
Posted by Mitch on January 11, 2002, at 22:26:50
In reply to Re: Eskilith CR/Lithobid, etc. » Mitch, posted by Chloe on January 11, 2002, at 16:09:22
> Mitch,
> Ok, now you have done it, fueled my obsession!!:)
>
> Eskilith CR vs Lithobid:
> The Eskilith CR is the hard yellowish tablet (450 mgs) that is scored. From what I have read about it, it's just very densely pressed Li and just breaks up slower on it's way out, so to speak.
>
> The lithobid (300 mgs), (which I prefer, since I don't seem to have the yucky side effects of increased sweating, nausea...) is the pink enteric coated tablet that isn't even digested in the stomach. This one I know I can't cut up. And you might be right about the dye causing some skin problems...I am so sensitive. I can't even use any creams or soaps with perfume, so a little dye might really be a culprit!
>
> Anyway, So I think it's safe to cut a scored 450 Eskilith CR in half without messing with the potency or absorbtion, do you?...I did NOT know that you could dissolve the reg lithium in juice. Why don't pdocs tell me these things? I am glad you are there to mention it!...
>
> However, I really do prefer the CR. I seem to have problems with reg. lithium and my blood sugar. I seem to get a surge of ?energy, jazziness?, and feel shaky. Then about 4 hours later, I have an energy, mood and BS crash. If I don't eat right away, I really lose it! That happened yesterday about 4 pm. Have you heard of the BS thing? I think I remember this from years ago, and that was one of the reason I didn't want to retry it...But I am glad I did. Li works very quickly for me. And there was some urgency as my therapist is headed out of town this week. I have been extremely needed related to my rapid cycling. I am so hoping that this small amount of li and the TCA will smooth things out so I can get through a day or two without a crisis...
>Oh, yes I have *done* so many different types of lithium it is ridiculous. Oh, except lithium *citrate*, have you done that one? I haven't tried it yet. It is supposed to be easier on your GI tract. I had a pdoc ask me about it once. Never went there, never done it.
I have done the Eskalith immediate release tablets (300mg), the slow-release 450mgCR tabs you are talking about, and the Eskalith 300mg immediate release capsules, and the 300mg Lithobid "pinkie" slow-release tablets that include some sodium, whew!Excuse me-I thought you had immediate release lithium available (obviously you didn't). That's why I brought up the OJ thing. If you crush up any of the stuff you do have, obviously it becomes immediate release, sorry. The Eskalith IR "pinkie" capsules are perfect for the OJ thing. Just open up a two or three and mix with xxxML of juice and drink xxxML per day, etc. That was what was in my mind's eye when I replied last. Hey, I just thought of something. You *could* do this OJ thing with pinkie IR Eskalith caps. You probably can choose to fill your RX generic as you like, right? You might try that.. NO dyes in there.
Oh, you *really* need to take your lithium with lunch or breakfast or something. That way it doesn't blast into your bloodstream so rapidly. If you can divide it into two doses per day, taking one with lunch and the other with a big snack a couple of hours before bedtime would work the best, IMO.
> Question? Why not retry the Amitriptline if it was really stabilizing for you? I think you said you are on Nortriptyline. How does that compare to Ami for you? My pdoc suggested that one as well. BUT I was on Ami in the eighties and liked the calming sedative effect. I recall that Nort. is more activating???
>
> Thanks
> Chloe
I don't think that *now* I would like the sedative properties of the amitrip. -because of the involving stressful detaily job I have now. I did sort of rethink about it today some. Notrip. is much easier for me to tolerate. It also works in combo with SSRi's a lot better. It's the only TCA that I didn't get blurred vision and dizziness on. Yes, it is more activating. But, not in an anxious way like you might think. Nortrip. is a good med for panic disorder, too. I found it works best in combo with a pinch of Zoloft or Celexa.Mitch
Posted by Chloe on January 12, 2002, at 9:39:11
In reply to Re: Eskilith CR/Lithobid, etc. » Chloe, posted by Mitch on January 11, 2002, at 22:26:50
Mitch,
Thanks for the info, but I am a little confused! The Eskilith CR, (not IR, I don't what that one is...) is a hard pressed pill that has no coating. It is the same color and consistancy thoughout the pill. AND the pill is scored, so I think it's ok to take half of the 450 mgs. I think it was designed to be split. So I am thinking that cutting the hard packed pill from 225 mgs into 112.5 isn't going to affect the controlled release. Do you have any thoughts on this one?And yes, I did try the citrate years ago. I remember it was hard on my stomach lining. It has alcohol as a stabliizer, and I remember it giving me some upset. But I probably didn't take it with emough for or something...
Thanks again, Mitch
Chloe
Posted by Chloe on January 12, 2002, at 10:27:24
In reply to Re: Eskilith CR/Lithobid, etc. » Chloe, posted by Mitch on January 11, 2002, at 22:26:50
> I have done the Eskalith immediate release tablets (300mg), the slow-release 450mgCR tabs you are talking about, and the Eskalith 300mg immediate release capsules, and the 300mg Lithobid "pinkie" slow-release tablets that include some sodium, whew!
DAH, Eskilith IR, immediate release! I am not firing on all cylinders at the moment. I got some IR tablets last night. They are impossible to cut up into 75's. So like you said, I dissolved some in cranberry juice(that's all I have in the house, not OJ) and it didn't dissolve well. And then the mixture turned black. OH yuck. This whole Lithium microdosing has becoming beyond complicated. I should ask for the citrate if my pdoc wants me to take such small amounts. I just feel like I am living at the pharmacy and giving them all my money...
I am still hoping cutting up the Esk CR is ok...I called a pharmacist and they didn't want to comment on breaking up Li tabs. I am sure because it lithium can be toxic, etc. But toxicity is clearly not an issue when I am taking about 100 mgs day.
Sorry to go on and on about this issue. But I can't get a hold of the pdoc til monday, the pdr offers no advise, and the pharmacist won't comment. And I am not thinking terribly clearly...
Best,
Chloe
Posted by Mitch on January 12, 2002, at 11:15:16
In reply to Re: Eskilith CR/Lithobid, P.S.! » Mitch, posted by Chloe on January 12, 2002, at 10:27:24
> I am still hoping cutting up the Esk CR is ok...I called a pharmacist and they didn't want to comment on breaking up Li tabs. I am sure because it lithium can be toxic, etc. But toxicity is clearly not an issue when I am taking about 100 mgs day.
>
> Sorry to go on and on about this issue. But I can't get a hold of the pdoc til monday, the pdr offers no advise, and the pharmacist won't comment. And I am not thinking terribly clearly...
>
> Best,
> Chloe
>
>
Oh, the pharmacist probably sees you as a "walking lawsuit" :-)Oh, here's the answer (I think) about the Eskalith 450mg CR tabs: I believe that the lithium is "microencapsulated", and it would be perfectly fine to quarter them just as you had intended. Otherwise, they woudn't have scored the tablets. So, just go ahead and quarter them without worry! Liquid medication has its drawbacks-I had a jug of liquid Paxil in the fridge (when I was trying it), and it worried me that some kid would get in there and drink it.
Mitch
Posted by Chloe on January 12, 2002, at 17:49:04
In reply to Re: Eskilith CR/Lithobid, P.S.! » Chloe, posted by Mitch on January 12, 2002, at 11:15:16
Thank you, Mitch.
You are so kind to keep hammering away with this lithium dilemma of mine. (Especially when my thinking/comprehension is a bit deminished.) I concur that it is "microencapsulated". It looks the same all the way through the pill.
Thanks for putting my fears to rest.
A most appreciative ChloeBTW, is Paxil grape flavored? No kid I know would drink my liquid Celexa. It's not bad, but it's certainaly not good tasting!! IMHO "-)
> Oh, the pharmacist probably sees you as a "walking lawsuit" :-)
>
> Oh, here's the answer (I think) about the Eskalith 450mg CR tabs: I believe that the lithium is "microencapsulated", and it would be perfectly fine to quarter them just as you had intended. Otherwise, they woudn't have scored the tablets. So, just go ahead and quarter them without worry! Liquid medication has its drawbacks-I had a jug of liquid Paxil in the fridge (when I was trying it), and it worried me that some kid would get in there and drink it.
>
> Mitch
Posted by Mitch on January 13, 2002, at 15:07:10
In reply to Re: Eskilith CR/Lithobid, P.S.! » Mitch, posted by Chloe on January 12, 2002, at 17:49:04
Posted by Claudia on March 1, 2002, at 13:47:09
In reply to Re: Eskilith CR/Lithobid, P.S.! » Mitch, posted by Chloe on January 12, 2002, at 17:49:04
My husband has just been diagnosed with depression. We realize now that he's been suffering with it for years. The doctor has prescribed 20 mg/day and he's been on it for 3 weeks with no relief and tons of side effects. I worry about him so much as he is really suffering and has changed dramatically in his personality. Reading all of your previous stories, I know this group can certainly relate. My question is, to you, who have actually lived through (or are living with) the depression and the prescribing of Celexa - how long does it really take before you started to feel better? We need some hope.
Looking forward to your reply. Claudia
Posted by cmcdougall on March 1, 2002, at 20:12:34
In reply to Celexa, posted by Claudia on March 1, 2002, at 13:47:09
Hi Claudia,
Celexa is known for causing relatively few side effects. I take 40mg (along w/ other drugs) and can honestly say that I haven't had any negative side effects. My other drugs cause dry mouth and constipation, but that is a small price to pay for overall benefit.
Everyone reacts to meds differently. Some get relief almost immediately, others need 4-6 weeks to feel better. Sometimes a med will not work at all or the side effects make it intolerable. Then you have to titrate down and start a different med. Some of us on this board have to go through 3 or 4 med trials before we find one that works. When you consider that each trial takes 3-6 weeks, you are looking at a considerable length of time to figure out what will work for you.
Exactly what side effects are bothering your husband? Most side effects decrease w/ time. I think thats what you and your husband need. As hard as it is, try to have patience. There is no magic bullet and if Celexa doesn't do the trick in another week or 2, you may have to try something different. The first thing to try is probably an increase in dosage. I think that 20mg is considered quite low (I could be wrong).
Also, be sure that your husband is seeing a psychiatrist for his medicine. Most GPs just don't have the experience to be prescribing these powerful drugs. I know that a lot of GPs will prescribe based on the recommendation of a couselor or psychologist, but I don't agree with it.
Love and luck,
Carly
Posted by Claudia on March 3, 2002, at 8:49:08
In reply to Re: Celexa, posted by cmcdougall on March 1, 2002, at 20:12:34
Carly,
Thanks for the support and words of wisdom. The side-effects he is suffering from are: loss of sleepiness (day), insomnia (night), restlessness, inability to concentrate, diahera, loss of sex drive to name a few. He doesn't like to go to work and it's a struggle to get there - and when there he can't concentrate. People are starting to ask questions and that's hard too.I realize from what I'be read that we may have to try a few. This is just # one and we were hopeful as it seems the drug with the best reported side effects - especially to do with sex drive. But so far, it's not helping the depression or anything else yet.
This is so difficult and we're trying to stay stong. Are any of you married? If so, how are your spouses/significant others dealing with this? How do they best support you? We are trying so hard to get through this - but some days it just feels like such a struggle for both us of. It's like so much has changed and logically you know why - but emotionally it's hard to accept.
Any further advice?
Claudia
Posted by misty99 on March 3, 2002, at 11:42:59
In reply to Celexa, posted by Claudia on March 1, 2002, at 13:47:09
> My husband has just been diagnosed with depression. We realize now that he's been suffering with it for years. The doctor has prescribed 20 mg/day and he's been on it for 3 weeks with no relief and tons of side effects
Hi Claudia,
As someone who has recovered from severe depression, it sounds like your husband is very lucky to have a supportive wife like you. Anyway to your concerns - my personal experience with Celexa was a disaster as I felt like I was going to die from a panic attack on 5mg. My psychiatrist wanted me to stick it out but I refused to.
I am one of the posters on this board who feels that if a med shows no sign of working after 2 weeks and there are still alot of side effects, it's time for a new med. In my "Need a translation post", I found a website that said a non response in SSRI meds is usually an indication that there will be no response down the road. Of course, they still stuck to the view that you need to stick it out and most psychiatrists, including your husband's, will probably feel the same way.
Of course, you and your husband have to make the decision but if I were in your husband's shoes and this situation was affecting my work, I would ask for another med. He has just started treatment and so there are plenty of options still to choose from.
I had the best luck with Zoloft so maybe that's an option for your husband since he seems to be reacting to Celexa somewhat like I did? But I am not a doctor so keep that in mind. Also, I took Adderall with it so again, Zoloft might not be appropriate for your husband
Good luck and tell your husband to hang in there as we all have been there, done that. If you have any other questions, post again.
Misty
Posted by bonnie_ann on March 3, 2002, at 12:22:21
In reply to Celexa, posted by Claudia on March 1, 2002, at 13:47:09
Claudia,
I have been taking Celexa for over one year anywhere from 10mg to 30mg. I felt best at 30mg.
My symptoms were more towards anxiety- I always was able to get up and go to work, just I obsessed and paniced for most of my day. I tried BuSpar first but that made me depressed.
It does take awhile to work at least 4 weeks.
After a while I added Wellbutrin to the Celexa for daytime tiredness and sexual problems.
As far as the marriage I always functioned, as far as the emotional side, it wasn't till after I had been in therapy for a year that I could talk to my husband without breaking down in tears.
It does get better, sometimes you have to go through the bad times first to get to the good times.
Everyone responds differently to medication and their are many to choose from.
Good Luck,
Bonnie
Posted by Taryn on March 4, 2002, at 15:45:27
In reply to Celexa, posted by Claudia on March 1, 2002, at 13:47:09
Claudia-
I have struggled with depression for years, and have been prescribed *numerous* medications. I have been on Celexa for just about a year. My Dr. started me at 20mg/day but that did nothing for me. He upped the dosage to 40mg/day and I noticed a change soon thereafter. I honestly felt like a new person. I encourage your husband to talk to his dr. and suggest increasing the dose. Hope everything works out for the best.
Posted by Claudia on March 4, 2002, at 18:03:13
In reply to Re: Celexa » Claudia, posted by Taryn on March 4, 2002, at 15:45:27
Thank you all so much for your words of wisdom and support. You ahve no idea how great it feels to have a little hope. We have a follow-up appt. wiht the Dr. this week - so hopefully he will up the medication and that might be what he needs. (Hopefully!)
I cna tell you one thing from this experience - I have SO MUCH respect for the people who suffer through this, their families and for the success stories I keep hearing about. Depression is a terribly misunderstood disease and can be so dibilitating - mentally, physically and last, but not least, socially. It's so sad more people dont understand it for what it really is. A true, a very common disease.
Thanks again for your words of support. I will keep you updated. Again, we're always looking for words of advice - so keep 'em coming if you think of any more coping strategies.
One question maybe you can help with - in any of your experiences, do you personally think this was just a chemical thing with you, or is it brought on my outside stresses and triggers? I know for a fact that in my husbands case he isn't dealing (well) with some very hard family issues, which is even harder for a guy to admit, and it's my belief that's what behind this. But, what do I know. I'm really just here as his partner tpo love him though this. I'd like to hear other people who are going through depression's opinion on the outside stress factor. That will lead to the next question as to whether medication alone has helped most people, or medication taken jointly with councelling of some sort.
Take care.
Claudia
:)
Posted by Daveman on March 6, 2002, at 22:41:00
In reply to Re: Celexa, posted by Claudia on March 4, 2002, at 18:03:13
Hi Claudia:
I was put on antidepressants last year after suffering what I guess our parents might have called a "nervous breakdown" (i.e., I had terrible insomnia, anxiety, and uncontrollable crying spells). I was first tried on Paxil, which had no positive effect; after four weeks, I was switched to Celexa. The Celexa began to work after about two weeks. At the third week, my doc added small-dose Remeron to help with my insomnia. The two drugs together (what we psych patients like to call a "cocktail")were very effective. There were side effects, mainly weight gain (about 25 pounds) and loss of some sexual function- a very fair trade IMO. There was some nausea in the start-up, but that went away after about two weeks.
I remained on 40 mg. Celexa/15 mg. Remeron until the first of this year. I have now tapered down to 20 mg. Celexa. Through intense psychotherapy, I have learned much about what happened to me. Some of it was undoubtedly a chemical imbalance, some of it was a build-up of many problems I had not dealt with, including residue from my father's death 20 years earlier. I also can see looking back now that I suffered for years from obsessional thinking, insomnia and occasional panic attacks. I should have dealt with these things years earlier, but like you say, it's hard for us guys to admit we need psycological help.
From my eperience I can offer the following advice: Be patient in trying to find the right medication. I know that when Paxil failed to work for me and I was switched to Celexa, I was so discouraged that I questioned whether my doctors knew what they were doing. I've learned since that many depressed patients have to try several medications before finding one that works. Perhaps Celexa will not be the one for your husband; maybe he'll need a different SSRI or perhaps Effexor (a medication used for patients who are treatment-resistant to the SSRI's). Maybe a combination of meds will do it. I know it is hard but stick with it.
My second piece of advice, which is related to the first, is to make sure you are being treated by a competent psychiatrist who understands these medications. Sad to say, but most general practicioners, well-meaning though they are, just are ill-equipped to deal with these medications. Many of them will buy into drug company propaganda because they have so little actual experience with these meds. This is where the false notion that SSRI's are some sort of "wonder drug" with "no side effects" comes from.
My third piece of advice is that when the right med combo is found, your husband needs to get in regular therapy with a competent psychotherapist. This is usually NOT the same person as the prescribing psychiatrist, as they are different disciplines (there are exceptions of course- in my case, both individuals happened to be part of the same medical group.)
Most of all remember that these problems did not arise overnight and will not be solved overnight. Stick with it, and keep in touch.
Dave
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